Monday, July 25, 2011

The Morning Drill: July 25, 2011

With more than 5 million people suffering from Alzheimer's disease in the United States, a number that's expected to rise to 16 million by 2050, the pressure is on to find better methods of diagnosis, treatment and prevention.

Around the world, Alzheimer's disease is the second most feared disease, behind cancer, according to a recent survey of five countries conducted by the Harvard School of Public Health.

Yet there is still a lot of misinformation: Only 61% of Americans who responded to the survey correctly identified Alzheimer's disease as a fatal illness. Many participants also mistakenly believe there are sure diagnostic methods and effective treatments to slow the disease, but most would seek medical attention if they became aware of their own early signs.

The research that came out of the Alzheimer's Association 2011 International Conference on Alzheimer's Disease, which took place in Paris last week, reflects a growing emphasis on early detection.

Research suggests the best targets for exploring treatments are patients who do not have full-blown Alzheimer's disease, but experience mild symptoms. Scientists have identified biological indicators called biomarkers that seem to be associated with Alzheimer's, although they are not perfect predictors. (...)

At the Paris conference, researchers said 3 million cases of Alzheimer's could be prevented worldwide if lifestyle-based, chronic disease risk factors were reduced by 25%. This estimate is based on a mathematical model.

In the United States, physical inactivity had the biggest association with Alzheimer's out of the risk factors studied, followed by depression and smoking. Midlife hypertension, midlife obesity, low educational attainment and diabetes are other risk factors.

"If we can demonstrate that these risk factors can be modified, and that it will lead to lower rates of Alzheimer's disease, the impact could be huge," Levey said.

People in their 40s and 50s have still got perhaps a couple of decades to modify lifestyle to potentially lower risk, he said.

Chickenpox vaccine has dramatically cut deaths from the disease, especially in children, says a new government study proclaiming an important public health victory.

Researchers from the Centers for Disease Control and Prevention found that chickenpox deaths fell from an average of 105 per year to 14 after the vaccine had been available for a dozen years.

Deaths declined in all age groups, but the drop was most significant among children.

"To see the near elimination of chickenpox deaths in this country is very exciting," said Jane Seward, a CDC official who co-authored the paper. She has been involved in the agency's chickenpox vaccine program for 15 years.

When the Patient Protection and Affordable Care Act (PPACA) was signed by U.S. President Barack Obama in March 2010, the law authorized the spending of millions of dollars to help Americans take better care of their oral health.

But with Congress locked in a battle to trim trillions from the federal budget and raise the nation's debt ceiling, key provisions designed to promote research, preventive programs, and oral health literacy languish without funding.

"We're talking about our economy collapsing rather than funding some important health initiatives," said Jude McCartin, a spokeswoman for Sen. Jeff Bingaman (D-NM), a leading congressional advocate for the oral healthcare provisions.

Meanwhile, funding for the current fiscal year has been blocked outright for another initiative, a $60 million program to allow states to set up pilot projects to try out alternative workforce models such as dental therapists.

The PPACA places a major focus on expanding the dental workforce, authorizing funds for training traditional dental providers, and exploring the use of new models.

At least 49 million Americans live in more than 4,000 areas lacking adequate oral healthcare services, and the U.S. would need nearly 10,000 additional practitioners to meet the needs of these shortage areas, according to the U.S. Department of Health and Human Services' Health Resources and Services Administration (HRSA). Moreover, 16 million beneficiaries are scheduled to join Medicaid in 2014, and a pediatric dental benefit has been included in essential benefit packages under the PPACA.

Seventy-five former professional football players are suing the National Football League, saying the league knew as early as the 1920s of the harmful effects of concussions on players' brains but concealed the information from players, coaches, trainers and others until June 2010.

The players "did not know the long-term effects of concussions" and relied on the NFL to protect them, the suit says.

The lawsuit also names as a defendant the football equipment maker Riddell Inc., which has been the official NFL helmet brand since 1989.

"For decades, defendants have known that multiple blows to the head can lead to long-term brain injury, including memory loss, dementia, depression and (chronic traumatic encephalopathy) and its related symptoms," says the 86-page lawsuit, filed in Los Angeles County Superior Court on Tuesday.

"This action arises from the defendants' failure to warn and protect NFL players such as plaintiffs against the long-term brain injury risks associated with football-related concussions. This action arises because the NFL defendants committed negligence by failing to exercise its duty to enact league-wide guidelines and mandatory rules regulating post-concussion medical treatment and return-to-play standards for players who suffer a concussion and/or multiple concussions."

NFL spokesman Greg Aiello said Monday night that the league had not seen a copy of the suit but would "vigorously contest any claims of this kind."